比较美国放射学会甲状腺影像报告和数据系统（ACR TI-RADS）分类与2015年美国甲状腺学会（ATA）指南推荐的超声特征对甲状腺结节的诊断价值。

回顾性分析2015年9月至2017年7月就诊于山西医科大学附属第一医院经手术或穿刺病理证实的218例共295个甲状腺结节（76个良性，219个恶性）的常规超声特征并进行ACR TI-RADS分类及ATA风险分层，分别与病理结果对照，绘制受试者工作特征（ROC）曲线，采用χ²检验比较2种方法的敏感度、特异度、阳性预测值、阴性预测值以及准确性，采用Kappa检验评价2种方法的诊断价值。

ACR TI-RADS分类与ATA风险分层ROC曲线下面积分别为0.889、0.902，二者差异无统计学意义（P=0.296），最佳诊断点ACR TI-RADS为TR5、ATA为高危，此时敏感度、特异度、阳性预测值、阴性预测值及准确性比较（85.4% vs 90.0%，88.2% vs 88.2%，95.4% vs 95.6%，67.7% vs 75.3%，86.1% vs 89.5%），差异均无统计学意义（P均>0.05），Kappa值=0.92。

ACR TI-RADS分类与ATA风险分层对甲状腺结节的诊断价值均较高，以ACR TI-RADS分类为TR5与ATA风险分层为高危作为诊断恶性的标准时，二者诊断价值一致性良好且诊断价值最高。

To compare the diagnostic value between the recommended ultrasound characteristics by the American College of Radiology thyroid imaging reporting and data system (ACR TI-RADS) and the 2015 American Thyroid Association (ATA) guidelines in thyroid nodules.

We retrospectively analyzed the conventional ultrasound features of 295 thyroid nodules (76 benign and 219 malignant) in 218 patients that were confirmed by surgery and puncture biopsy pathology from September 2015 to July 2017 at the First Affiliated Hospital of Shanxi Medical University by the ACR TI-RADS classification and ATA risk stratification. The results were compared with the pathology results. The receiver operating characteristic (ROC) curve was then plotted. The χ² test was used to compare the sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of the two methods to evaluate their diagnostic value.

The areas under the ROC curves of the ACR TI-RADS classification and the ATA risk stratification were 0.889 and 0.902, respectively, and there was no significant difference between them (P=0.296).The best cut-off points for ACR TI-RADS and ATA were TR5 and high risk, respectively, and the corresponding sensitivity, specificity, positive predictive value, negative predictive value, and accuracy were 85.4% vs 90.0%, 88.2% vs 88.2%, 95.4% vs 95.6%, 67.7% vs 75.3%, and 86.1% vs 89.5%, respectively (P>0.05, Kappa=0.92).

Both ACR TI-RADS classification and ATA risk stratification have high diagnostic value in thyroid nodules. Using TR5 and high risk as the respective cut-off points of the ACR TI-RADS classification and ATA risk stratification has good consistency and highest value for the diagnosis of thyroid malignancy.